Introduction To investigate whether the use of levonorgestrel intrauterine device (LNG-IUD) in controlled ovarian hyperstimulation (COH) affects the pregnancy outcomes and recurrence of women with poor ovarian response (POR) and endometrial cancer (EC) and atypical endometrial hyperplasia (AEH) after fertility sparing treatment.

Methods A retrospective cohort study of EC and AEH women after fertility sparing treatment with POR who received in vitro fertilization and embryo transfer (IVF-ET) from January 1, 2010 to March 31, 2023. All patients received at least one COH cycle with or without LNG-IUD. A generalized estimating equation (GEE) was used to compare the pregnancy outcomes of controlled ovarian hyperstimulation (COH) and the recurrence of EC and AEH.

Results 23 EC and AEH patients after fertility sparing treatment with POR received IVF were included in the study. 8 cases with LNG-IUD underwent 36 cycles (LNG-IUD group) and15 without LNG-IUD completed 45 cycles (non-LNG-LUD group). There was no significant difference in COH outcomes between these two groups. The clinical pregnancy rate was 20.51% (8/39). The study cohort’s cumulative live birth rate (CLBR) was 23.53% (4/17). At a median follow-up time of 55.82 months (IQR 21.24,93.95), 4 patients recurred before COH while 2 patients after COH. None of the patients in the LNG-IUD group experienced recurrence after COH.

Conclusion/Implications Women with POR and endometrial cancer and atypical endometrial hyperplasia after fertility sparing treatment achieved satisfactory pregnancy outcomes after repeated COH with LNG-IUD. At the same time, LNG-IUD might prevent the recurrence of endometrial cancer.

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Abstract EV170/#949 Figure 1